Active NPI
Cristina Michelle Mena Zambrana, OD
- Optometrist
- Rio Grande, PR
National Provider Identifier
1003587627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 754
- Practice address
- Rio Grande Town Center Carr 3 Suite a-19
Rio Grande, PR 00745 - Phone
- (787) 988-7061
- NPI assigned
- Sep 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 754 | PR | Primary |
Addresses
Primary practice location
Rio Grande Town Center Carr 3 Suite a-19
Rio Grande, PR 00745
Mailing address
772 Calle Gema
San Juan, PR 00926-5806
Other practice location 1
Palma Real Carr 3 suite 170
Humaco, PR 00791
Phone (787) 850-5222
Other practice location 2
Plaza Fajardo Carr 3 Suite 125
Fajardo, PR 00738
Phone (787) 801-5896
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220303000084 | PR | Practitioner - Optometry | 3779977087 |
Reassigns benefits to 1 organization Practice locations: Fajardo, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 754 | PR | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ecb Humacao | Optometrist | Current | Accepting new patients |
| Ecb Humacao LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Fajardo, PR
- NPI 1104604768
-
- Optometrist
- Caguas, PR
- NPI 1164237269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1003587627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "772 CALLE GEMA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009265806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RIO GRANDE TOWN CENTER CARR 3 SUITE A-19",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "00745",
"telephone_number": "787-988-7061"
}
],
"practiceLocations": [
{
"address_1": "Palma Real Carr 3 suite 170",
"address_purpose": "LOCATION",
"city": "Humaco",
"state": "PR",
"postal_code": "00791",
"country_code": "US",
"telephone_number": "787-850-5222",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Plaza Fajardo Carr 3 Suite 125",
"address_purpose": "LOCATION",
"city": "Fajardo",
"state": "PR",
"postal_code": "00738",
"country_code": "US",
"telephone_number": "787-801-5896",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENA ZAMBRANA",
"first_name": "CRISTINA",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-23",
"last_updated": "2024-12-12",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rio Grande, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.